Transforming Care Through Housing Pipeline and NHSE Capital Support
The focus is on offering a variety of housing options early in planning processes to reduce inpatient numbers and provide settled accommodation for individuals with tailored care needs. Emphasis is placed on moving Transitional Care Patients (TCP) to more independent housing settings, reflecting local housing strategies and TCP Housing Plans. NHSE Capital Grants support initiatives catering to individuals with Learning Disabilities, Autistic Spectrum Disorder, and possible Mental Health needs. Collaboration with various stakeholders is essential for effective implementation.
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Housing Pipeline & NHSE Capital to supporting Transforming Care Jane Bellwood: NW Housing Lead NHS England jane.bellwood@nhs.net HLIN NW Feb 2018 www.england.nhs.uk
Building the Right Support to reduce inpatient numbers by 50% Dec 2016. People should be offered a choice of housing, including small- scale supported living (ideally 6-8, but schemes can be bigger as this depends on design just don t want large institutions again) Choice about housing should be offered early in any planning processes (most have 3.5 and 5 yr discharge plans ) Where people live, who they live with, the location, the community and the built environment need to be understood from the individual perspective Everyone should be offered settled accommodation (not residential offers) The future needs of this group needs to be represented in local housing strategies, and TCPs Housing Plans.. So planning for future.. Not just the immediate need www.england.nhs.uk 2
Challenge for the North 897 people in March 2017 40% have been in hospital for > 5yrs Aim to move 391 TCP patients by March 2019 Also people in transition & At Risk of hospital admission or who have no move on options from semi- secure accommodation to more independent housing settings Often Housing is considered after care and support not Housing First In reality Choice and Control for people is limited 3TCPs in NW : GM, C&M, Lancs & S. Cumbria 2/3 have new TCP Housing Plans: demand & how this is being met All need to reflect Council Supported Housing Plans development (for LD/ASD and Transitions) within their planning Housing Options need to include Step Up (Crisis) or Step Down (Rehab) NHSE Capital Fund provides 20M opportunity to support building the right home www.england.nhs.uk
NHSE Capital Grants (20M p.a.) From 2017 to 2021 ( 80m) but only part of this was allocated last year For settled and short-term housing options for children, young people and adults with Learning Disabilities and/or Autistic Spectrum Disorder, but may have Mental Health needs also Capital for buildings & land for new or remodelling or in-built equipment to adapt to meet personalised needs - but schemes can be part of larger footprint (Residential/ Step-Down/ ECH ) if residential fits best for the cohort it can be supported. Packages of care often have clinical support, so mixed funding Capital Bids need to come via CCG or in GM via Health and Social Care Partnership with Local Authority and/or Housing Providers, submitted via CCG sponsor 4
HealthCommissioners: Focused on existing needs and care and support right in the community to enable move on, discharge planning takes time. Lead Commissioners: Bespoke housing is expensive it takes time, can only afford some of it - not for all. Its no one s role to look at the housing requirements so it can get missed Service Users: want their own front door, option that gives independence & security of having onsite/shared care. Housing Providers: LAs & Health not always ready to engage on what s needed or affordable, not always able to find space to work up solutions e.g. build new, adapt existing, HOLD shared ownership, shared space. Care and Support Provider: talking to LAs about possible solutions, capital, and links to Housing Developers but not easy to link potential housing solutions to local plans Some partners think Specialist Architect: Service User and Provider dialogue is key cutting corners with this will mean the brief won t be right for the client/s, we get one type for all then tenancies may fail All parties have something to bring about improvement: make Housing a key enabler to delivering quality care/support, independence & choice
Live Capital Bids in NW opportunities for more? Liverpool CCG: Step through facility Lancashire CCG: Bespoke 3 x 6 (2 bed) bungalows with sleep in and crisis beds Wigan CCG: Various bespoke individual options. Others in North: - South Tees : Transitional accommodation for CYPS forensic and urgency care/crisis provision Newcastle and Gateshead: 3 apartments x 5 bedrooms, crisis rooms and self contained flats Sunderland : 3 bids for remodelling existing spaces for personalised needs Full list available with final presentation www.england.nhs.uk 6
Learn more and get in touch https://www.housinglin.org.uk/_assets/Resources/Housing/ OtherOrganisation/building-right-home-guidance- housing.pdf NW NHS E Housing Lead : Jane Bellwood: can support: Development of capital bids and help with submissions Development of housing plans for TCPs with Partners Links with CCG and Council Housing Leads with LGA Links with TCPs in the North West jane.bellwood@nhs.net Mob: 07702 406740 www.england.nhs.uk
CCG Description Amt 462,000 Liverpool North Mersey Hub Specialist Residential Provision Belle Vale. 3 bungalows with 6 beds Newcastle Gateshead Transforming Care Newcastle & Gateshead - 3 x self-contained apartments, each containing 5 en-suite, accessible bedrooms and a dedicated communal space within each apartment area & 3 crisis rooms and 1 self-contained flat (crisis) Development of forensic Crisis bed for South Tees Locality. The self-contained flat will be developed on the site of a scheme which is currently under development by Middlesbrough Borough council and Mencap 280,000 South Tees 80,000 South Tees Kirkleathan Integrated Care Centre (KICC) - Childrens & Young People provision - 6 accommodation units, 3 for long term admissions/residential, 2 respite beds and an emergency/urgent care bed. Beds will be of flexible use, i.e. health, joint or social care. develop the existing detached Annexe into a self-contained two bed apartment 200,000 Sunderland 85,000 Sunderland change the existing two person apartment into a one person apartment with two bedrooms. 40,000 Sunderland The proposal would be to redevelop the lower ground floor apartment into a self-contained 2 bed apartment. It would enable direct access to separate front door. Northumberland Plans have been drawn up for the erection of 5 additional bungalows on this 0.8 acre site (five x two bedroom additional bungalows are built on this site to support four clients in single occupancy accommodation and the fifth bungalow to be used for emergency respite) South Tyneside There will be 2 individual flats, with a kitchen, bathroom, sleeping and living area There will also be a staff area with appropriate facilities. Sheffield Development of 32 new building across 4 within Sheffiield Leeds Leeds Bid 1: Burley Willows: the provision of a specialised community residential facility for people with learning disabilities and/or autism who display behaviour which challenges. Leeds Leeds Bid 2: Single Supported Living Property Lancashire To develop alongside Housing and Support providers 3 x flexible supporting housing bungalow schemes consisting each of 6 properties that could accommodate people in single or shared tenancies 75,000 864,435 100,000 672,000 3,413,512 260,000 1,125,000 West Lancashire LD WL 1 West Lancs 43 Mayfield avenue house refurbishment 261,791 Wigan Purchase and refurbishment of property in Wigan for complex forensic patient 100,000 Bradford MANORLEY LANE, BRADFORD: development includes 16 x 1 bed specialist supported living apartments. Branshaw Respite and Supported Living Scheme Scheme 1 - New build Short Break (respite) service Scheme 2 - New build bungalows Supported Living 140000 Bradford www.england.nhs.uk 1,661,855
Sample schemes supported by NHES Grants: 1) Lancashire PCT Proposal for 3 schemes in different areas: offering 6 x 2 bed bungalows for single or shared tenancies for adults with autism or/and learning disabilities. They will offer a private but linked garden, with a pathway providing safe passage around the site as needed. The capital funding for the development will be shared between NHSE and the Local Authority and a Registered Social Landlord (RSL). On site provider background support will be delivered via a single staff unit, with the option to incorporate a staff sleep-in room at each site. Assistive technology will be integrated into the scheme, as well as a community room that provides electronic access to community information and space for clinicians to meet and work with tenants. The staff garden will offer a community allotment/or other similar project to support communal projects outdoors. Crisis support for be offered for tenants or community within one of the bungalows. A safe area will be provided for the person in crisis and the staff, providing an opportunity to deescalate the crisis through providing space between the individual and others. This will address a local gap in service and provide the opportunity for crisis support when needed to prevent and admissions and readmissions. 2) Proposal focuses on redevelopment of an existing LD service/site, with the aim of providing a step- through service for those who are part of TCP in partnership with third sector provider. The service will operate a residential model. There are plans for 3 bungalows providing a total of 16 units. CQC have been consulted and are supportive of the design and plans. Each bungalow will provide shared lounges, kitchen and breakout areas. This will allow for individualised support in a safe environment, to enable service users to develop their independent living skills in a community setting. The aim of the service is to support transition onto more independent living, with the space and support available in the community. Also it will allow for intensive work with patients to enable them to remain in the community, using active support and positive behaviour models. There will be a range of multi- disciplinary clinical skills available and a staff team that deliver individualised care to service users in crisis or who are learning new skills. Merseyside PCT www.england.nhs.uk
